Nursing Elites

1. What finding would lead healthcare providers to suspect Turner syndrome in a child?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.

2. Which of the following findings would indicate altered mental status in a small child?

• A. Recognizing the parents
• B. Showing fright at the EMT-B's presence
• C. Displaying a lack of attention to the EMT-B's presence
• D. Maintaining consistent eye contact with the EMT-B

Correct answer: C

Rationale: In a small child, displaying a lack of attention to the EMT-B's presence would indicate altered mental status. This behavior suggests a diminished level of consciousness or awareness, which is concerning. Recognizing the parents (Choice A) is a normal and expected behavior for a child. Showing fright at the EMT-B's presence (Choice B) may indicate fear or anxiety but not necessarily altered mental status. Maintaining consistent eye contact with the EMT-B (Choice D) may indicate engagement or curiosity rather than altered mental status.

3. A child is being assessed for suspected intussusception. What clinical manifestation is the nurse likely to observe?

• A. Projectile vomiting
• B. Currant jelly stools
• C. Abdominal distension
• D. Constipation

Correct answer: C

Rationale: The correct clinical manifestation that a nurse is likely to observe in a child with suspected intussusception is abdominal distension. Intussusception is a medical emergency where a part of the intestine folds into itself, causing obstruction. Abdominal distension is a common symptom due to the obstruction and the build-up of gases and fluids. While currant jelly stools (Choice B) are a classic sign of intussusception, they are typically seen in later stages of the condition and may not be present during the initial assessment. Projectile vomiting (Choice A) is more commonly associated with conditions like pyloric stenosis. Constipation (Choice D) is not a typical manifestation of intussusception; the condition usually presents with severe colicky abdominal pain and possible passage of blood and mucus in stools.

4. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: Avoiding gluten is not typically necessary for managing gastroesophageal reflux disease (GERD) in children. The correct dietary instruction for a 2-year-old with GERD would be to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux symptoms. While spicy foods and dairy products may also trigger reflux in some individuals, the primary focus should be on avoiding high-fat foods due to their direct impact on the lower esophageal sphincter, which exacerbates GERD symptoms.

5. When teaching a class of new parents about positioning their infants during the first few weeks of life, which position is safest?

• A. On the back, lying flat
• B. On either side, lying flat
• C. Head slightly elevated on the left side
• D. Head slightly elevated on the right side

Correct answer: A

Rationale: The correct answer is A: 'On the back, lying flat'. Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position helps ensure the baby's airway remains clear and reduces the likelihood of suffocation. Choices B, C, and D are not as safe as placing the infant on their back, as they may increase the risk of accidental suffocation or SIDS.

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